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Wiley Document Transcript

  • 1. Reviews Independent Comment on Audio-Visual and Print Materials 101 Healing Stories for lives, including technology, in order to join of family theories and creates some big waves. There have been few family therapy them at a personal level and to incorporate Kids and Teens: Using text books which so immediately ‘reach’ me these elements into our metaphors and thera- as this one. Is it because Johnson and peutic storytelling. He recommends that Metaphors in Therapy. Whiffen combine thinking about the indi- therapeutic stories are more impactful and vidual and her emotional experience with effective if they are congruent with a child’s George W. Burns. Hoboken, NJ, attention to interactions within relation- age, development, gender and cultural John Wiley & Sons Inc, 2005. ships? Is it due to each chapter being packed context. He also cautions against magical with relevant clinical examples, with a Soft. Pp. 293. ISBN 0-471-47167-4. $74.95. endings or fantastic outcomes that take place strong eye to the theoretical links? Yes to outside of the subject’s problem-solving skills In this sequel to 101 Healing Stories, Burns both! However, I suspect as much as these or competencies and hence are based on expresses the hope that his books will teach achievements, it is the genuine authentic ‘false hope’, which does not empower the lis- new therapists how to construct and apply ‘voice’ of the text which appeals to me. It tener. He similarly urges practitioners to metaphors in their work and will assist expe- manages to speak of the suffering of the avoid ‘negative outcome stories’. rienced practitioners to locate stories in their human condition without theoretical obfus- 101 Healing Stories For Kids and Teens is work and to enhance their skills. He offers cation. The editors define attachment a ‘how to’ book more suited to the begin- the suggestion that parents and carers can also theory as ning therapist/counsellor dealing with use stories and metaphors in teaching values individual children, than to the family ther- a systemic theory that focuses on behav- to children, and in developing personal and apist working with the whole familial unit iour in context and patterns of relationship competencies and accountability. or those already acquainted with Milton communication … [which] can also Burns suggests that metaphors involve both Erickson and others. While it is useful and been seen as an individual dynamic art and skill and are ‘purposefully designed well presented, its attempt to talk to an theory, one that focuses on internal symbolic communications’ applied to ‘spe- American as well as Australian audience working models and ways of perceiving cific healing and therapeutic intentions’ and others (9). lessens its potency, and seems to be at odds states that his aims are to ‘teach and to heal’ with the author’s urging to write stories This is one of the major contributions of AT; through stories. which are culturally and contextually spe- a model of human behaviour which concep- The author seems to talk with and to cific and congruent. tualises what goes on within people whilst teach his readers through an indirect story- Perhaps some of the challenge facing being linked to what goes on between people. telling manner, and in this might be seen as Burns is the tension between his ‘teaching’ In the first section of Attachment replicating the metaphoric style in the of the core elements of metaphor construc- Processes, we are given an introduction to content and process of his subject matter. tion, and encouragement of others to the dynamics of attachment relationships. He tells a large number of stories, each of construct and apply their own stories. He This is followed by a description of the which addresses a specific problem through provides so many therapeutic stories that nature of couple and family relationships, identifying the resources the subject charac- some readers may rely on his 101, rather from cradle to grave. Subsequent chapters ter needs to develop or rediscover, and than create their own and further expand concern infants, adolescence, culture, same- identifying the outcomes achieved. More their skills. 101 Healing Stories for Kids, nev- sex couples, fostering, chronic pain, child experienced practitioners might find the ertheless, is a helpful guide to those looking sexual abuse and depression; all from within number of exemplar metaphors to be some- to develop an understanding of metaphor in an attachment-theory framework. Each what excessive, inhibiting their individual therapy applications, and skills in locating chapter begins with a review of the concepts impact. These stories can blur if read one or constructing them. of AT which pertain to the theme being after the other, without some time or space Keith E. Sedgman examined. The reader is then led through between them so as to allow the ideas to Sedgman & Associates Counselling an explanation of characteristic interper- seed and grow. Services, Brisbane sonal patterns and how these can be Burns makes the reasonable point that understood by considering different attach- stories and metaphors are available through ment styles and patterns of interaction. films, TV, advertisements, MTV videos and Attachment Processes What I found impressive and illuminating other media, and that these provide access in Couple and was the discussion of theoretical proposi- to and insight into our children and teens tions alongside relevant research findings. and valid avenues to converse with them. Family Therapy. The research outcomes are then linked with He believes in the importance of stories as case examples. conduits of personal and societal communi- Susan Johnson and Valerie Whiffen John Bowlby is the architect of AT. cation, and was a personal investment in (Eds), NY, 2003. Johnson and Whiffen suggest that his 1944 giving all a voice to maintain communica- paper ‘Forty-Four Juvenile Thieves: Their tion, which celebrates the place of Hard cover. pp.410. ISBN: 0 898627 303. Characters and Home Life’ is one of the storytelling as part of cultural and relation- US $42.00. first family therapy articles. Curious to ship currency. Johnson and Whiffen’s Attachment Processes think now that it was published in the Burns is specific in urging therapists to keep abreast of aspects of our young client’s puts attachment theory (AT) into the pool International Journal of Psychoanalysis. 111 ANZJFT Volume 26 Number 2 2005 pp. 111–116
  • 2. Reviews Bowlby’s observations on both animal pital professionals, maternal and child health constructions. We do need to understand the impact of the mother/primary caregiver nurses, mental health clinicians. That is to behaviours and human attachments led to on the infant’s emotional development. This say, it’s a book for just about anyone who his seminal three-volume work; Attachment ‘first couple’ has been relatively slow in being works with the suffering of the human con- (1969), Separation (1973) and Loss (1980). a central determinant to family relationship dition — the infants, the elderly, and just These ideas, which became the foundations formation. In Attachment Processes, this about everyone in between. of AT, were initially taken up by develop- omission is addressed. mental researchers. Family therapy Some chapters incorporate other practi- References practitioners and theorists did not do so tioners’ work, such as Herrman’s 1992 work until the late 1980s. Bowlby stated that Bretherton, I., 1991. The Roots and Growing with trauma. The chapter ‘Attachment-Based ‘seeking and maintaining contact with sig- Points of Attachment Theory. In C. Family Therapy for Depressed Adolescents’ nificant others is an innate, primary Parkes, J. Stevenson-Hide & P. Marris demonstrates ways family members can motivating principle in human beings across (Eds), Attachment Across the Life Cycle, repair relationship damage. Using the the lifespan’. He identified that dependency London, Tavistock/Routledge. concept of forgiveness, the authors draw par- has become pathologised by our culture. Bowlby, J., 1944, Forty-four Juvenile Thieves: allels between the attachment repair task and Dependency, Bowlby argued, is an innate Their Character and Home Life, models of trauma recovery. The research on part of being human rather than a child- International Journal of Psychoanalysis, 25: forgiveness is interwoven closely with a case 19–52, 107–127. hood trait that we outgrow (1988: 5). The example of a mother apologising to a dis- authors of Attachment Processes therefore Bowlby, J., 1969. Attachment and Loss. Vol 1. tressed daughter. This is different from other restate Mackay’s (1996) observation that Attachment, NY, Basic. family work models in that it places the ther- family therapy has tended to focus on the Bowlby, J., 1973. Attachment and Loss, Vol 11. apist as a central investigator, mediator, analysis of power and control whilst nurtu- Separation: Anxiety and Anger, NY, Basic. translator and interpreter of family relation- rance has been overlooked. Bowlby, J., 1980. Attachment and Loss. Vol ships and someone who structures Subsequently researchers have begun to 111. Loss: Sadness and Depression. NY, intervention to achieve a particular desired explore changes in emotional security during Basic. outcome. Of course this is what many thera- life-cycle changes. A secure attachment Bowlby, J., 1988. A Secure Base, NY, Basic. pists do, with or without family members implies that there is a secure base from Chodorow, N., 1989. Feminism and present. The authors describe a staged model which individuals can explore their world; Psychoanalytic Theory, New Haven, CT, of therapy informed by attachment theory; this is done by relationship interdependency, Yale University Press. mother and daughter have individual ses- not separation. Felt security is ‘new’ lan- Clulow, C. (Ed.), 2001. Adult Attachment and sions with the therapist, and then joint guage in family therapy, especially if we Couple Psychotherapy, Hove, East Sussex, sessions leading the mother into a dialogue think of it as being closely related to past Brunner-Routledge. which facilitates repair. The chapter articu- events, conscious and unconscious processes Ernst, S., 1987. Living with the Sphinx, lates how the therapist offers herself as the and attributed meanings. AT explains that London, The Women’s Press. ‘secure base’ for therapy to be successful. proximity to significant caregivers is the way Herrman, J., 1992. Trauma and Recovery: From Therapeutic neutrality, it seems, has been humans manage strong feelings of fear and Domestic Abuse to Political Terror, London, given a fresh challenge. anxiety. If we feel close to our attachment Pandora/HarperCollins. If there is a criticism, it is that the psy- figures we are more able to manage strong Hoffman, L., 1981. Foundations of Family choanalytic roots of AT are not adequately feelings, if they are inaccessible we can feel Therapy, NY, Basic. acknowledged, as they are in Clulow (2001). distressed. Bowlby viewed emotional distress Mackay S. K., 1996. Nurturance: A Neglected In Bowlby’s first volume of his seminal work in close relationships as often being an Dimension in Family Therapy with Attachment (1958), he wrote attempt to make contact with an inaccessible Adolescents, Journal of Marital and Family Therapy, 22: 489–508, (quoted in attachment figure. … as my study of (attachment) theory Johnson, S. & Whiffen, V. E., Family Some of the older shibboleths of family progressed it was gradually borne in Processes). therapy have been questioned by AT. For upon me that the field I had set to Sarah Jones example, Hoffman in her seminal book plough so lightheartedly was no less Melbourne than the one that Freud had started Foundations of Family Therapy argues ‘dyadic tilling sixty years earlier, and that it con- transactions seldom occur; interaction is tained all those same rocky excrescences either triadic or group’ (73). AT challenges An Introduction and thorny entanglements that he had this with some very powerful research. The encountered and grappled with — love to Marriage and chapter ‘The First Couple’ refers to the and hate and anxiety and defence, mother and her infant. The infant symp- Family Therapy. attachment and loss (Preface, xi). toms, such as feeding, sleeping, and behavioural regulation difficulties, while not Johnson and Whiffen do not however explore Lorna L. Hecker and Joseph L. apparently relational, ‘commonly reflect diffi- how Bowlby and Freud tilled the same soil, Wetchler (Eds). NY, Haworth, culties in the relationship between the nor how this has been subsumed by later 2003. pp. 625. mother and her infant’ (216). This state- developments and applications of AT. ment may sound a challenge to feminist Here is a text in which one can taste or Paperback. ISBN 0-7890-0276-0. US $46.95. therapists. However psychoanalytic feminists one can feast. This is just the book that such as Nancy Chodorow and Sheila Ernst The blurb includes the statements ‘easily could reach the whole array of family and et al. have developed a body of work explor- takes the place of five or six other resources couple therapists, parent–infant therapists, case managers, family support workers, hos- on my bookshelf’ and ‘what an amazing col- ing and examining similar observations and 112 ANZJFT June 2005
  • 3. Reviews lection of knowledge … this book does research with Carr (2001) and Nichols and Stern (2004) has called the ‘present moment’ exactly what an introductory text should do’. Schwartz (2004), using the criteria men- in psychotherapy. Reading this, my interest rose, as I am tioned in the opening paragraph. The In my view, Fisher writes clearly yet elo- always on the lookout for introductory history and schools chapters in both Carr quently about how to facilitate therapy material for students which is readable, com- and Nichols and Schwartz met the criteria sessions so that couples experience a signifi- prehensive and succinct, compares ideas, whereas those in this book met few. For cant and transformative encounter in the situates these in context and includes cri- example, concepts were not situated in the present moment of therapy — an experien- tique. A big ask, one might say, but not evolutionary history of family therapy and tial encounter that can act as a reference impossible. there was no comparative analysis or critique point for ongoing change/difference in the The book comprises two parts with and, in the history chapter, there was ele- relationship. Fisher articulates his approach numerous chapters within each. Part 1 is mentary material left out. However, the in a very ‘how to’ and user-friendly format. entitled ‘Theories in Marriage and Family research chapter in this book is well-written It is laced with examples and snippets of Therapy’ and includes the obligatory history, and comprehensive, highlighting dilemmas, couple therapy transcripts. His work is systems theory and cybernetics chapters and examining alternative methodologies and underpinned by principles of nonviolence various chapters on different schools of reporting the current status of research. It and mindfulness. It challenges both therapist family therapy. Part 2 looks at special issues compared favourably to that in Nichols and and clients to achieve and work in a reflec- in marriage (sic) and family therapy. This Schwartz and was far more comprehensive tive and self-aware space This space involves section covers a range of subjects and than that in Carr. Such a comparison is a working at a different level and pace than includes chapters on marriage enrichment rough road test but one, nevertheless, which that required by ordinary conversational and premarital counselling; sexual dysfunc- doesn’t encourage me to substitute this book consciousness or problem solving. tion and sex therapy; gender, culture and for other texts already on my shelf. Nichols (1987) wrote about the spirituality; and ethical, legal and profes- dilemma of how to pay attention not only to sional issues. References the relationship and wider systems, but also Each chapter is written by a different to the individual when working with rela- Carr, A., 2001. Family Therapy: Concepts, author who has obviously followed a tem- tionships. Fisher provides a way of achieving Process and Practice, Chichester, Wiley. plate, a wise idea given there are 20 authors both/and in terms of honouring the intra- Nichols, M. P. & Schwartz, R. C., 2004. involved. However, despite this, quality varies psychic and interpersonal arenas of couple Family Therapy: Concepts and Methods (6th substantially, with some chapters providing edn.), Boston, Pearson. experience. Another integration that Fisher’s material which is clear, succinct and compre- approach achieves is one between experience Chris Hunt hensive, and others providing good examples and meaning making. In this way Fisher is Lecturer, School of Medicine, University of of how not to write. With so many authors able to incorporate postmodern influences Queensland, private practice, Brisbane involved, this book does not develop the sense and have them sit alongside key psychody- of flow and comparative analysis that emerges namic relationship concepts. Experiential in texts written by one or two authors. In the approach advocated in this text, The book is firmly aimed at the US Psychotherapy with Fisher sees the role of the couples therapist market; for example, the editors provide a as a cheerleader to the unfolding of self and Couples — A Guide for list of US graduate programs in family and experience in the moment by managing marriage therapy, and include the AAMFT consciousness, tracking and contacting expe- the Creative Pragmatist. Code of Ethics; authors use US-specific rience and the information that it provides. case-examples. Although this may make the He is careful in his approach to strive for Rob Fisher. Phoenix,AZ, Zeig,Tucker text valuable for students in the United learning from direct experience rather than & Theisen, 2002. States, it’s a detraction for overseas readers. attempting to achieve a curative experience Moreover, the history chapter makes barely a Paperback. pp. 265. ISBN 1-891944-97-5 from catharsis itself. The book clearly sets nod to influences outside US borders. (Alk. Paper). US $44.95. out the principles and underlying philoso- Having said this, I should note there are phies that underpin the experiential In September last year the 25th Australian inconsistent attempts to include interna- approach and then describes the macro and Family Therapy Conference in Brisbane had tional material (e.g. in a list of family micro processes involved in experiential as its theme ‘Getting it Together: Family therapy journals, the ANZJFT gets a couple work. Fisher and his approach to Therapy Practice for the Future’. The stated mention but the JFT does not) and the couples counseling challenges the couples aim of the conference was to make a contri- description of narrative therapy and its therapist to be able to: bution towards integration by bringing genesis is definitely idiosyncratic. The fact • ‘track with a soft focus’ (receive rather together the field’s theoretical and practice that Hecker & Wetchler has a strong focus than go after) wisdom. Rob Fisher’s text Experiential on couple therapy as well as family therapy • engage with all their humanity Psychotherapy with Couples is more than a will be attractive to some readers. In addi- • have a high tolerance for uncertainty guide for the creative pragmatist — it is a tion, the chapter on legal, ethical and • give up on the notion of client resistance professional issues covers an important area guide for the integrated (dare I use that word • be able to hold more than one point of often not highlighted in other texts. eclectic) creative pragmatist. Whilst being view simultaneously To be a useful introductory text, it has strongly grounded in the process (experien- • adjust their use of self to the needs of to cover the basics well. I compared its chap- tial and somatic frame of therapy) this very clients ters on the history of family therapy, practice-focused guide also privileges the • be active and not violent particular schools and family therapy therapeutic relationship and what Daniel 113 ANZJFT June 2005
  • 4. Reviews His three sections address ‘Working in a therapeutic setting without the protec- might just be a reminder of what is yet to tion of an official learning title (intern, Experientially with Couples’, ‘Character come, and that we all are likely to benefit student on placement). Theory and Couple Therapy’ and from reading this book. The areas covered seemed well thought ‘Integrating the Experiential Approach Maria Nichterlein through and useful for practice. They range with Traditional Theories of Assessment Senior Counsellor, La Trobe University, from personal motivation to do the work, and Practice’. Melbourne difference with professional practices, The experienced reader will recognise getting accustomed to working in the bilin- much of what Fisher says. It is not so much Using Workbooks in gual world of mental health services (where his ingredients but the mix that makes this Mental Health: family therapists will need to negotiate a unique and valuable book to have, not on tension with the inherently psychiatric lan- your shelf — but always at hand on your Resources in Prevention, guage of other mental health practitioners), desk. Experiential Psychotherapy with dealing with documentation and values con- Couples is truly a comprehensive and very Psychotherapy and flicts (including dual relationships of readable guide for the creative and prag- Rehabilitation for different sorts), dealing with ‘stuckness’ and matic couples therapist. with legal interface, and longer-term issues Clinicians and of avoiding burnout, and becoming a References ‘master therapist’ while still keeping one’s Researchers. Nichols, M., 1987. The Self in the System, NY, head on one’s shoulders. Brunner/Mazel. I found myself agreeing with most of Luciano L’Abate (Ed.). Binghamton, Stern, Daniel, 2004. The Present Moment in what the authors wrote, at the same time NY,The Haworth Reference Press, Psychotherapy and Everyday Life, NY, wishing that something similar were written Norton. 2004. by an Australian team. For if there is a cri- Paul Simmons tique that The Practical Practice needs, it is pp. xxvii +398. Soft cover. ISBN 0-7890-1593- Professional Training Manager, that its strength is at the same time its weak- 5. US $49.95. Relationships Australia Queensland ness. Any practice is necessarily based in the Luciano L’Abate has written extensively in idiosyncrasies of the place and the people the field of family psychology and psy- The Practical Practice that constitute such practice. The more chotherapy. He has published a number of practical a tool wants to be, the more local it of Marriage and Family handbooks of family psychology, marital will become. This book is no exception: in interventions and sourcebooks. Using attempting to be a ‘practical practice’ written Therapy: Things My Workbooks highlights the potential use of in the context of clinical practice in the Training Supervisor workbooks in rehabilitation, prevention, and United States of America, the authors speak psychotherapy. to new graduates who not only have been Never Told Me. L’Abate is both editor and one of a differently trained, but who also have had to number of contributing authors from Italy negotiate their anxieties in relation to the Mark Odell & Charles E. Campbell. and the United States. The book is in five context of North American psychotherapeu- Binghamton, NY, Haworth, 1998. sections. The first, written by L’Abate, looks tic practice, including the nightmares of at the possible roles for workbooks in mental managed care and their licensing practices Soft cover. pp. 276. ISBN number: health and then explores the current research (which include professional placements as 0-7890-0431-3. US $27.95. on workbooks and their effectiveness. It part of their training). The authors speak a identifies the successes and the challenges Notwithstanding my nearly 20 years of clin- language that is soothing to that population, that workbooks need to meet in order to ical experience, I found myself enjoying but which might be off-putting for newly fulfil their future role as the ‘medicine of reading this book. For although it is geared graduated therapists who are struggling with psychological interventions’. to an audience of newly graduated clini- our own set of problems (including our Throughout the developed world, cians, much in the book is useful to reflect interest in maintaining some autonomy of health services are struggling to counter the on and review, no matter how experienced thinking from an ever increasingly dominant rising levels of morbidity due to mental one is, since the issues at stake do not allow — and globalising— discourse of what illness. L’Abate proposes that workbooks can for a ‘final word’, a ‘right answer’. mental health is and how services should be be used to improve both the accessibility of The title clearly and unambiguously provided and evaluated). In this sense, I mental health services and the clinical effec- introduces us to what the authors want to would have preferred the book to articulate tiveness of services delivered. Through the convey. This is a fair attempt to talk about some alternative practices to dealing with use of workbooks and the incorporation of the nitty-gritty elements of our daily practice managed care and the use of DSMIV diag- new technology such as the Internet, the in ways that training centres often, and to nostics other than just assuming that, in possibilities for reaching larger populations varying degrees, do not have opportunity order to survive, a new clinician needs to be for preventive, promotion and early inter- and/or inclination to cover in their teach- able to speak the two languages and accom- vention activity are increased. At the ings. This is done in a fairly informal style modate systemic thinking to the mainstream individual level, L’Abate argues that treat- that is ‘matter of fact’ and which, I would psychiatric talk. ment from clinicians can be improved assume, would be very attractive to a new But again, if we accept the idea that through the use of workbooks that provide graduate who might be experiencing a fair we are living in times of increasing glob- alisation and cultural imperialism, this evidence-based, standardised interventions dose of anxiety in relation to starting work 114 ANZJFT June 2005
  • 5. Reviews that then can be clearly evaluated for effec- and development of workbooks. Where trainee and experienced therapists to reflect tiveness. L’Abate does not pull any punches on their ideas about what are the crucial this book succeeds is that it introduces the when critiquing current talk-based therapies credentials for a therapist. Burkham dis- reader to a range of new ideas and solutions compared with the written word, but he also cusses how clients can maintain the to the problems that are facing mental acknowledges the need for more research benefits of therapy beyond short-term health services today. into the effectiveness of workbooks. symptom relief, with expansion to explore David William Duerden The second section focuses on the use of family of origin patterns. The exploration Family Therapist & Occupational Therapist, workbooks to address a variety of problems, of the role of medication in the emotional InforMH, NSW Health including depression, abusive relationships, process of therapy is extremely useful. substance abuse and working with incarcer- I was disappointed that while research The Therapy Triangle: ated individuals. Some of the chapters on therapy outcomes and why people come provide a good insight into the functioning to therapy is cited, it is not referenced. This Empowering You with of the workbook but are light on research, seems to assume that the client audience is whilst others have a strong research compo- not concerned about evidence and sources. I the Knowledge to Heal. nent but leave you wanting to know more think that a book written for clients about about the application. Interestingly the what to look for in a therapist and how to Robert Burkham, 2002. E-book. pp. chapter ‘Healing the Trauma of Abuse: A play a central role in getting good outcomes 118. US $15 US. Women’s Workbook’, while not formally from therapy makes for compelling reading www.therapytriangle.com researched, provided the most interesting for the therapist. I have already started rec- and helpful insights into the functioning of ommending it to motivated clients who the workbook. have found it useful. Worth a read! Emotional Cutoff: The third section is on couples. The first Emotional Cutoff is a monumental book Bowen Family Systems chapter in this section examines the use of which takes one of Bowen’s eight theoretical workbooks for marriage preparation and concepts and explores it from multiple Theory Perspectives. maintenance programs in northern Italy. angles. While Burkam’s e-book is Bowen’s The context of the development of the pro- thinking simplified, this book is expansive Peter Titelman (Ed.) Binghamton, NY, grams is presented, and a comprehensive and complex. Haworth Clinical Practice Press, 2003. analysis of its effectiveness is provided. The The concept of emotional cutoff was following chapter discusses the use of home- used by Murray Bowen to describe ‘the Soft Cover. pp. 500. ISBN 0 7890 1460 2. US work in couple therapy and provides some process of separation, isolation, withdrawal, $37.46 (if ordered online from www.haworth- reviews of recommended workbooks for use running away, or denying the importance of pressinc.com) with couples. The section concludes with the parental family’ (Bowen, 1978, The Therapy Triangle is an e-book written for the analysis of one workbook designed to Titelman: 310) The function of cutoff is to clients about how to make the most of improve intimacy in couples. relieve relationship tension, yet ‘in the long therapy. It provides a unique description of The section devoted to families begins run the cutoff does not change the emo- clients’ dilemmas in seeking and undertak- with description of a manual for school tional patterns that brought about these ing effective therapy, which is useful for refusal in adolescents and a review of work- tensions, so they tend to reoccur in the next clients and therapists alike. The theoretical books and relevant literature on eating generation’ (285). underpinning is Murray Bowen’s model of disorders. The most compelling chapter con- The reader is taken on a rich journey family systems, which Robert Burkham tains the evaluation of using workbooks to into Bowen’s systems thinking through the translates into a clear applicable format. improve intimacy with couples who are experiences of therapists writing about The book revolves around the central parents of a handicapped child. This chapter themselves in their own families, case concept of the therapy triangle, where the is drawn from Milan-systemic work per- examples and reflections on biological and client hopes the therapist will take their side formed in northern Italy, societal processes. It has something for to fix others. Burkham writes that it ‘is The concluding section examines the both the novice and experienced systems natural for clients and professionals to form status and future of workbooks in the therapist. Students of Family Systems a therapeutic alliance in opposition to the delivery of mental health. There are defi- thinking can gain ready access to the person that the client wishes to change’. nite implications for workbooks in early theory through the personal stories of Each chapter describes a hypothetical client intervention and prevention programs. therapists. Those with a thorough under- and therapist working through family rela- L’Abate concludes that the challenges for standing of Bowen’s clinical applications tionship tensions. the use of workbooks will be met through will be stretched by chapters on cutoff, As one who has struggled to curb my a research agenda. and the brain, reproduction and emo- own programming in over-responsibility, Using Workbooks, while not an easy tional cutoff, and Israeli– Palestinian my favourite section of the book was the read, is interesting for clinicians and stu- Relations. Some of the case examples chapter titled ‘The Good, the Bad and the dents who are looking for an introduction provide useful resources for our clients Overly Helpful Therapist’. Of particular to workbooks. It attempts to cover both who are grappling with how to reconnect interest is the discussion of ‘the overly their development and implementation in with family members and what are the helpful therapist’ which parallels the rela- different fields of psychotherapy. This is a benefits of doing so. Klever’s chapter on tionship between an overprotective parent large task and not always successful, ‘Marital Functioning and Multi- and his/her children. I thought that this however some of the weaknesses may be a generational Fusion and Cutoff ’ and reflection of the need for further research was an excellent discussion, stimulating Ferrara’s chapter on ‘The Continuum of 115 ANZJFT June 2005
  • 6. Reviews Emotional Cutoff in Divorce’ are must- Jenny Brown in this issue) but on the However, to my mind the successful outcomes reported in such papers could reads for couple therapists. Other chapters whole, his earlier edited compilation The equally have been due to other factors: the covering abuse and violence add much to Therapist’s Own Family (Aronson, 1987) therapists’ ‘non-anxious presence’ and insis- the debate on whether power and control scores over its two successors, because, tence on ‘factual questions designed to dynamics get lost in attempts to place vio- apart from lively and varied contributions, defuse emotionality’ (a factor stressed by lence in a broader relationship context. it contains far less repetition. several authors), or the quietly provocative In chapter 15 on child abuse, Walter The besetting fault of Clinical line of questioning that many Bowenians Howard Smith writes that Applications of Bowen Family Systems Theory, use (‘How are you able to get your spouse so like Emotional Cutoff, is that almost every readers are cautioned not to interpret a upset?’ ‘What helps you to be less reactive to contributor has dutifully ploughed through focus on family interaction as decreasing your differences with each other?’ ‘How does Bowen’s key theoretical concepts, even the responsibility of abusing family going along with your husband’s abuse affect though Titelman has exhaustively presented members for their violent behaviour … the pattern?’). This type of questioning them in the first two essays of the volume. Each of us is responsible for our behav- shows the clear continuity between the The result is a book which is, by my calcula- iour, even if it is an aspect of a broader Bowenian tradition, and some more recent tion, about twice as long as it needed to be, family emotional process (352). therapies based in the strategic use of lan- and very tedious if read from cover to cover. This is a book to dip into at the level that guage to achieve therapeutic leverage. Titelman is an extremely experienced thera- engages each reader, rather than necessarily a My other disappointment, I suppose, pist and teacher within the Bowen system, book to read from cover to cover. The was that while all the authors proved adept but he is no editor — or else the need for opening chapters focusing on theory run the at applying Bowen’s concepts to practice, rigorous editing of the whole book is seen as risk of overwhelming readers who are unfa- hardly any of them seemed able to think irrelevant because of Haworth’s assembly- miliar with Bowen, so that they give up critically about the concepts themselves. In line method of producing new clinical before reaching the more accessible chapters. Emotional Cutoff, for example, Fran books: get an editor, assemble contributors, It is a book to return to over many years. As Ackerman (443–475) uses Bowen’s terms to print their contributions virtually unedited I read, I felt that I was being taken on an describe the Palestinian–Israeli standoff, but for content (but broken up with lots of sub- intensive course in family systems theory, fails to achieve any new insight into the con- headings), and treat each chapter as if it were being taught by a diverse and experienced flict by so doing. She does not allow the a separate article in a journal. faculty who have been grappling with this intractable special features of the ‘case’ to Having said that, I did find that one theory for decades. I also could see myself, modify the theory. Similarly in this volume, way of deciding which contributions to read my family and my own patterns of relating few of the authors appear able to go beyond first was simply to read the first pages of the- under stress written throughout the pages, Bowen’s own limits. This is unfortunate, for oretical introduction to each. Those authors which prevented this book from becoming Bowen’s theory is a fairly comprehensive and who were able to present Bowen’s ideas in a just an intellectual exercise. My mind was thought-provoking one, if unfashionably fresh way, suggesting that they had really stretched and my heart was engaged: the ‘modernistic’. Let’s have more of the kind of ‘made them their own’, were the ones that I measure of an excellent clinical resource! stretching and challenging of the theory that chose to read first, on the assumption that if Jenny Brown Betty Carter and Monica McGoldrick have they could do this with the theory, then The Family Systems Institute, done in the past. In particular, the biological probably their case studies would be worth 30 Grosvenor St, Neutral Bay, concepts in which the theory is rooted need reading too. This applied to, for example, Sydney, NSW 2089. careful examination (for example, the Bennett I. Tittler’s ‘Family Systems www.thefsi.com.au Bowenian parallel between the ‘separateness Treatment of Depression’ (227–247) and to force’ that drives cells to reproduce by divid- Phil Klever’s ‘Marital Fusion and ing in two, and the ‘separateness force’ that Clinical Applications Differentiation’ (119–145). impels human beings to individuality of Despite the many clear and interesting of Bowen Family thought within a complex interpersonal clinical presentations in this book, and system. And when does the wish for ‘sepa- Systems Theory. although I am personally sympathetic to rateness’ cease to be ‘healthy’ and become Bowen’s theory and methods, I have to say the unhealthy ‘emotional cut-off’? I am not Peter Titelman (Ed.) NY, Haworth, that I did not find many of the case studies suggesting these concepts are necessarily 1998. particularly convincing evidence for the par- misleading or wrong, only that few ticular usefulness of the theory. In several Bowenians seem prepared to go back to the Pp. 423. Soft cover. ISBN 0-7890-0469-0. cases, the successful outcomes were attrib- biological basics and think them through for US$39.05. uted by the authors to the fact that clients themselves (Bowen himself referred to bio- had been encouraged to undertake signifi- ‘Of the making of books there is no end’, logical concepts with minimal referencing, cant family of origin reconnections, e.g. and to the perpetuation of this enduring taking them as ‘givens’). Tittler’s chapter on treating depression, and truth the Haworth Press notably con- Hugh Crago James B. Smith’s ‘The Use of Bowen Theory tributes! Peter Titelman’s volume of essays Co-editor, ANZJFT in Clinical Practice with the Elderly’ on Bowen’s theory in clinical practice pre- Private Practice, Artarmon and Blackheath, dates his Emotional Cutoff (reviewed by (205–225). NSW 116 ANZJFT June 2005